GIÁ TRỊ CỦA CHỤP CẮT LỚP VI TÍNH TRONG PHÁT HIỆN XÂM LẤN TĨNH MẠCH THẬN Ở UNG THƯ TẾ BÀO THẬN: ĐỐI CHIẾU VỚI MÔ BỆNH HỌC

Abstract

Objective: To analyze the imaging characteristics of renal vein invasion on CT in patients with RCC and to evaluate the diagnostic value of CT in detecting this pathological feature. Methods: A retrospective descriptive study was conducted on 82 patients diagnosed with localized RCC who underwent nephrectomy at Binh Dan Hospital from 2020 to 2024. All patients had contrast-enhanced abdominal CT scans prior to surgery. CT findings suggestive of venous invasion were compared with postoperative histopathological results. Results: Histopathological analysis confirmed renal vein invasion in 24.4% of patients. CT features of venous invasion included intraluminal soft tissue density (18.3%), venous dilation (14.6%), and loss of clear fat plane between the tumor and renal vein wall (12.2%). The diagnostic performance of CT in detecting renal vein invasion demonstrated a sensitivity of 75%, specificity of 93.7%, positive predictive value of 75%, and negative predictive value of 93.7%. Conclusion: CT is a valuable imaging modality for detecting renal vein invasion in patients with RCC. Nonetheless, subtle or microscopic invasion may be missed, highlighting the need for comprehensive image interpretation combined with clinical correlation to improve staging accuracy.